Chronic pain is an important public health issue, affecting many children and potentially leading to significant interference with daily functioning and quality of life. Despite high prevalence rates, very little clinical trial work has been undertaken in children with chronic pain. Psychological therapies, in particular, cognitive-behavioral family therapy (CBT) interventions have shown promise for decreasing chronic pain. However, the availability of CBT is limited by many factors including distance to major treatment centers and expense. This study will advance scientific knowledge of pediatric pain interventions by developing and evaluating the efficacy of a more accessible treatment approach for chronic pediatric pain using a web- based family CBT treatment. The first aim of this study is to develop and test the feasibility of a family CBT intervention delivered via the Internet. The second aim is to conduct a randomized controlled comparison of a family CBT intervention to standard medical care, where the CBT intervention group is hypothesized to have significantly decreased pain, increased daily capabilities and function, improved mood, and improved quality of life. The third aim of the study is to examine depression as a moderator of treatment response, where children with higher baseline depressive symptoms are hypothesized to show the least improvement with treatment. Participants in the proposed trial will include 72 children, ages 11 to 17 years, experiencing chronic musculoskeletal pain and associated functional disability, and their parents. Children and parents will be provided with a laptop computer to complete eight treatment modules on a web site developed for the proposed study. Standardized measures of pain symptoms, functional disability, depression, and quality of life will be obtained before treatment, post-treatment (at 8 weeks) and at 3-month follow-up. The data obtained from this R21 application will be used to create effect size estimates for the efficacy of family CBT in children with chronic pain and will be used as the basis for an R01 application to conduct a larger, multisite RCT of the web-based treatment. It is anticipated that findings from this study will demonstrate that the Internet is effective for delivering family CBT to children with chronic pain. Such advances may be critical to reaching the large numbers of patients who are not able to receive psychological treatment in their communities, thereby reducing unnecessary burden and costs on the health care system. [unreadable] [unreadable] [unreadable]